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Complete the sheet below and tell us about your project or contact us for more information at office@chemodynamics.com.

Please enter the following information for us to know your specific requirements…
1. Contact Information (* indicates Required information)
Company Name *
Your Name*
Your Position
Your Address
City, State, Country
E-mail *
Phone *

2. Service(s) Required(select all that apply)
Contract R&D
Process Development
Small-scale Synthesis (mg – kg)
Kilo-scale Synthesis
Impurity Isolation, Identification and/or Synthesis
Small Lots Manufacturing
Analytical Development

3. Project Qualifications (select all that apply)
non-cGMP
cGMP
Schedule II – V Controlled Substance

4. Compound Name
5. Amount of Compound to be Prepared

6. Other Project Information (e-mail any documents to office@chemodynamics.com)

7. Timing
Immediate
4–8 weeks
8-12 weeks
Other – >> <<

8. How did you hear about Chemo Dynamics ?

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